Cross-contamination, Part II

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Uh-oh. Given the operating premise of Cross-contamination, Part I—that it’s best practice to prevent your clients from seeing each other’s images—what happens when the unthinkable occurs and, despite your best efforts to keep things under wraps, you accidentally give Client A a piece of paper that has Client B’s artwork on the backside? Once Client A creates an image on it and you later realize that the paper features traces of both Client A and Client B, you have some decisions to make. Who does the paper belong to? Who doesn’t it belong to? How will you acknowledge your breach? How will your relationships survive this breach?

This unfortunate situation happened to me not once, but twice. As a nomadic art therapist going from campus to campus within a school district, I have to pack quickly after one session before I head on to the next. I used to carry a gigantic suitcase that featured three different-sized pockets in the front that were perfect for holding paper of various dimensions. Organizing unused paper was a cinch. But when it came to hanging on to works in progress or transporting finished art products back to my office for storage, things became trickier.

The first time disaster struck, a client on the autism spectrum wound up drawing on the back side of an image that had been created by a depressed client. When I had packed her artwork into my suitcase, I’d apparently put it in backwards and thus mistook it for another sheet of blank paper. I thought I would never make that mistake again, but eventually a client with sensory processing issues wound up making Spirograph art (of course some holes were poked through the paper during the process) on the back side of an oppositional client’s image.

So what would you have done? When you, the protector, symbolically slide into the role of the perpetrator, how do you regain your clients’ trust? I sought supervision on this issue. In the first scenario, I ultimately decided to offer my apologies to the client who was cognitively able to understand the situation: the depressed girl. While the boy on the autism spectrum was drawing on the back of her artwork, I had caught a glimpse of her image and tried to stop him. Although I explained the situation to him, he thought I was trying to interrupt his process and take away his art. He became agitated and possessive of the piece of paper, clearly not grasping the situation. So I expressed regret to the girl the next time I saw her. She was visibly disappointed that I had not protected her by not protecting her image, which she never saw again, but she continued to work with me until she no longer needed my services.

In the second scenario, it was actually the boy with sensory processing issues who held up his work to the light and saw someone else’s image on the back. His stunned face twisted into a look of disgust as he wordlessly showed me the paper. He’d been pleased with his efforts up until that point, and his abrupt change in affect clearly indicated that he held me responsible for setting him up to fail. He was reluctant to accept my apologies but continued to work on a different sheet of paper, which ultimately improved his mood. However, he rejected the compromised piece of paper. So later in the week I presented the oppositional boy with the pierced paper and my regrets. Like the girl’s face in the first scenario, his face also conveyed disappointment in my failure to protect him. However, he quickly transformed his hole-riddled drawing into a bullet hole-riddled drawing and appeared pleased with his clever solution. Thus some of his anger toward me made its way into his creative process and was released. In the end, my relationships with both clients were eventually redeemed.

Now instead of a gigantic suitcase, I carry a huge portfolio of papers and a smaller suitcase of supplies. In addition to papers, the portfolio also contains two smaller portfolios, one for works in progress and one for completed works that will be transported back to my office for storage until termination or the end of the school year, whichever comes first. Since adopting this organizational system, I haven’t mistaken client artwork for blank paper. But if I should make that error, I know that the solution is relational and cannot be addressed with a one-size-fits-all approach. Deciding how to handle breaches of confidence, even if they are symbolic, requires consideration of the circumstances at hand. And most importantly, they require promptness, transparency, and personal/professional accountability. Let’s face it; cross-contamination happens…and so does credibility.

With appreciation for the important work you do,

Megan March 2014

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This is a thumbnail of Colorful art macro, which was released into the public domain by Summer Woods. Click here for more information.

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Art therapy is a regulated mental health profession; standards of competent art therapy practice in the U.S. require a graduate education in art therapy as well as supervised post-graduate training in art therapy. The information presented on this site is not intended to serve as a substitute for these requirements, but it may enhance the reader's understanding of the use of art in assessment and treatment.